Prevalence and Risk Factors of Erectile Dysfunction Among Diabetics

Aim of Study: To identify prevalence and risk factors associated with prevalence of erectile dysfunction among diabetic men. Patients and Methods: A hospital-based cross sectional study design was followed to include 402 male diabetic, married patients attending the Diabetes Clinic at King Abdul-Aziz University Hospital in Riyadh. The abridged five-item version of the International Index of Erectile Function (IIEF-5) was used to diagnose the presence of erectile dysfunction (ED). Pertinent clinical and laboratory characteristics were conducted. The level of control of diabetes was assessed according the level of HBA1C. Results: ED was prevalent among almost three-fourths of diabetic patients (74.9%). Almost one fourth of patients developed ED before the age of 50 years (23.6%), while almost half of them developed ED during the age period 50- 70 years (46.3%). Potent diabetic patients, compared with diabetic patients with ED, were significantly younger (49.92±9.29 Vs. 58.83±9.68 years, p 0.001), having shorter duration of diabetes (8.17±6.43 Vs. 14.65±8.01 years, p 0.00 1) and with better diabetes control, i.e., lower HBA1c (7.85±1.56 Vs. 8.65±1.53, p 0.001). There was no significant difference between both groups as regard body mass index. According to educational status of diabetic patients, prevalence of ED was significantly higher among less educated diabetic patients (p 0.001). As regard occupation, the highest prevalence of ED was among retired (89.7%) and unemployed patients (87.5%), while it was least among professional workers (50%) and office workers (65%). Differences were statistically significant (p 0.001). Prevalence of ED was highest among diabetic patients with least monthly income (100%). Prevalence rates were shown to decline significantly with increasing monthly income (p=0.033). Although prevalence rates of ED are higher among smokers and morbidly obese diabetic patients, yet, there are no significant differences as regard prevalence rates of ED according to smoking status or body mass index. Excellent and good grades for diabetes control were higher among potent diabetic patients, while fair and poor grades for diabetes control were higher among patients with ED. Differences were statistically significant (p 0.001). Hypertension and ischemic heart disease were significantly more prevalent among diabetic patients with ED (p 0.001 for both). Moreover, lack of exercise was significantly more observed among patients with ED (p=0.004). However, there were no significant differences between normal diabetics and patients with ED as regard hyperlipidemia, presence of thyroid disease, or exposure to pelvic surgery or trauma. Conclusions: Diabetes is a major risk factor for ED. Most associated comorbidities with diabetes are hyperlipidemia and hypertension. Most common risk factors are aging, longer duration of diabetes, improper glycemic control, concomitant medications (e.g., diuretics and antacids) low income, low educational level and lack of exercise. It is recommended that ED should be inquired about by primary health care physicians among all diabetic men, especially those with comorbidities and risk factors.